scholarly journals Referral rates of patients with diabetes to secondary care are inversely related to the prevalence of diabetes in each primary care practice and confidence in treatment, not to HbA1c level

2021 ◽  
Author(s):  
Q.Z. Siah ◽  
N.H. Ubeysekara ◽  
P.N. Taylor ◽  
S.J. Davies ◽  
F.S. Wong ◽  
...  
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Hba1c Level ◽  
Primary Care Practice ◽  
Care Practice ◽  
Referral Rates ◽  
Patients With Diabetes

scholarly journals Improving Patient Access to Diabetic Retinopathy Screening Through Telemedicine

Iproceedings ◽  
10.2196/15193 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e15193
Author(s):  
Tiffany Wandy ◽  
Michael Kiritsy ◽  
Daniel Durand
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Primary Care Practice ◽  
Primary Care Providers ◽  
Care Practice ◽  
Type I ◽  
Screening Measure ◽  
Diabetic Retinopathy Screening ◽  
Patients With Diabetes ◽  
Retinopathy Screening

Background The LifeBridge Health (LBH) Accountable Care Organization (ACO) serves approximately 20,000 Medicare beneficiaries, many of whom have type I or type II diabetes. Diabetic retinopathy (DR) screening is extremely important in helping to preserve patient’s eyesight and overall functional status. However, like many other organizations, LBH has struggled with low compliance rates for DR screening. As result, LBH searched for a solution to improve DR screening care and improve ACO quality and financial performance. Objective LifeBridge sought a telemedicine diagnostic solution that was easy for our physicians and clinic teams to use that would enable improved management of patients with diabetes. A pilot was initiated at three large primary care practice locations in the last quarter of 2017. Two of the locations received table top cameras, while the other location received a more mobile, hand held unit. Working with a dedicated LBH IRIS team, the practices created and implemented workflows, documented processes, and instilled best practices. Methods We used a pre-post test design to measure whether implementation of this tool enabled providers to better meet the diabetic retinopathy screening measure. We included the final months of 2017 in the preperiod to account for any operational changes required to implement the new workflow. Manual chart abstraction of patients seen in the previous 4/6 weeks who were eligible to determine the proportion of patients who met the measure. This was done quarterly in every primary care practice throughout the organization. One of the three practice sites was changed halfway through 2018 and switched to another; however, both practices were included in the analysis. We also compared the number of diabetes patients in the populations of each of the four practices. A two sample z test with a P value of .05 was used to test for statistical significance. Results As of April 2019, 810 patients were screened for diabetic retinopathy. Of these, 33.1% (282 patients) were diagnosed with pathology. Approximately 15.6% (n=133) were diagnosed with DR. We also identified 87 patients who are considered “IRIS saves” patients who had pathology identified that was serious enough to put them at imminent risk of losing their sight. For all patients requiring follow up, direct referrals were made to our in-network ophthalmologists at Krieger Eye Institute for treatment that these patients would not have otherwise received. Statistical comparison of DR screening performance of practices pre and post implementation showed mean screening rates of 38.5% and 47.2%, respectively, with P=.01. Conclusions IRIS screenings allowed our primary care providers to provide more comprehensive care to patients with diabetes, eliminating the need for additional office visits. Having IRIS available in the practice was able to demonstrably improve performance in the diabetic retinopathy screening measure. As a result, primary care providerss with IRIS helped facilitate access to care, thus making it easier for patients make better choices related to their health outcomes. We hope to further use the data to study HbA1c control, medication adherence, and cost/utilization in those diagnosed with retinopathy compared to those with a negative screening.

scholarly journals Developing and implementing linked electronic medical record and administrative data in primary care practice for diabetes in Alberta

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Neil Drummond ◽  
Matt Taylor ◽  
Stephanie Garies ◽  
Marta Shaw ◽  
Boglarka Soos ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Administrative Data ◽  
Primary Care Practice ◽  
Clinical Care ◽  
Family Physicians ◽  
Care Practice ◽  
Patients With Diabetes ◽  
Diabetes Patients

IntroductionUse of administrative health data and primary care electronic medical record data are both ubiquitous in Alberta, but linkage between them at patient level and implementation of the linked data into primary care practice are rare. This demonstration project sought to achieve this for a sample of patients with diabetes. Objectives and ApproachAcademic family physicians in the Department of Family Medicine at the University of Calgary who participate in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) identified diabetes–related variables, either in their EMRs or in administrative data, that they wished to obtain in a linked dataset. Secure data linkage was obtained through Alberta Health Services (the provincial health authority) following transmission of patient mapping files direct from the clinics. The de-identified, linked, patient data was then transferred to CPCSSN-Alberta data managers for processing and displayed to users through an interactive Diabetes Dashboard. Results2598 patients with diabetes were identified using a validated CPCSSN case definition from 47 family physicians in three clinics. CPCSSN EMR data included primary care encounters, date of diagnosis, deprivation index, BMI, blood pressure, comorbidity, diabetes medications prescribed, risk factors, etc. Administrative data included laboratory results (HbA1c, fasting blood glucose, cholesterol, triglycerides, creatinine), medication dispensed, emergency room visits, inpatient admissions and costs. Integrated, interactive provider reports were created and sent to participating physicians. The reports presented the information about diabetes patients at individual provider level, bench-marked at clinic, primary care network and provincial levels. Follow-up with providers led to further dashboard development . We propose to scale up implementation of the integrated diabetes database and dashboard to include all 23,000 CPCSSN-identified diabetes patients in Alberta. Conclusion/ImplicationsIntegration of EMR and administrative data and its application to clinical care, panel management, and quality improvement in primary care, as well as to surveillance and research, was feasible and acceptable to the family physicians participating in this project.

Improving Colonoscopy Referral Rates Through Computer-Supported, Primary Care Practice Redesign

2009 ◽  
Vol 31 (4) ◽  
pp. 43-53 ◽  
Author(s):  
Michael K. Magill ◽  
Julie Day ◽  
Annie Mervis ◽  
Steven M. Donnelly ◽  
Mary Parsons ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Care Practice ◽  
Referral Rates ◽  
Practice Redesign

Development and implementation of a culturally tailored early childhood program in an integrated pediatric primary care practice.

2020 ◽  
Vol 8 (3) ◽  
pp. 288-297
Author(s):  
Tyanna C. Snider ◽  
Whitney J. Raglin Bignall ◽  
Cody A. Hostutler ◽  
Ariana C. Hoet ◽  
Bethany L. Walker ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Childhood ◽  
Primary Care Practice ◽  
Pediatric Primary Care ◽  
Care Practice ◽  
Early Childhood Program ◽  
Culturally Tailored ◽  
Childhood Program

scholarly journals Antibiotic prescribing pattern in primary care practice in Federal Territory Kuala Lumpur and Putrajaya

2020 ◽  
Vol 101 ◽  
pp. 92
Author(s):  
A.H. Lim ◽  
S.Y. Thian ◽  
Y.Y. Hor ◽  
S.T. Wong ◽  
W.Y. Tew ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Care Practice ◽  
Antibiotic Prescribing ◽  
Kuala Lumpur ◽  
Prescribing Pattern
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